Bone surgery tools

Abstract

The bone surgery tool (1) comprises: a main body (2) which is cylindrical and has a through hole (2a) penetrating the main body (2) in the longitudinal direction of the main body (2) and for inserting a rod-shaped component; a receiving part (3) arranged at a distance from one end of the main body (2) in the longitudinal direction and opposite to the one end of the main body (2) in the longitudinal direction; and a hook-shaped support (4) connecting the main body (2) and the receiving part (3), wherein the receiving part (3) receives one end of the rod-shaped component penetrating the through hole (2a) of the main body (2).

Description

Technical Field

[0001] The present invention relates to tools for bone surgery. Background Art

[0002] Bone resection surgery is performed for the purpose of improving the symptoms of osteoarthritis of the knee, and one of the surgical methods of bone resection surgery is DTO (Distal-tuberosity osteotomy). Fig. 12A DTO and general HTO (high tibial osteotomy) are described. DTO is different from HTO in the position of bone resection relative to the rough surface, and in DTO, bone resection is performed at a position farther than the rough surface.

[0003] like Fig. 12B As shown, in DTO, when the knee is movable, the rough surface is stretched by the knee tendon attached to the bone fragment near the tibia, and a load in the direction of separation is applied to the rough surface. In order to suppress the load on the rough surface, it is important to tighten the rough surface from the front to the back on the distal bone fragment of the tibia. Since there are nerves and blood vessels on the back of the tibia, it is particularly important to insert the screw in the appropriate direction in the tibia, and therefore, it is necessary to make a lower hole in the appropriate direction by a drill bit. A drill guide is used in the production of the lower hole performed by a drill bit (for example, referring to patent documents 1 and 2).

[0004] Prior art literature

[0005] Patent Literature

[0006] Patent Document 1: Japanese Patent No. 4988693

[0007] Patent Document 2: Japanese Patent No. 5868923 Summary of the invention

[0008] Problems to be solved by the invention

[0009] In the case of the drill guides described in Patent Documents 1 and 2, the tip of the drill that penetrates the bone is exposed to the surrounding tissue.

[0010] The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a bone surgery tool capable of preventing the tip of a drill bit that penetrates a bone from being exposed to surrounding tissues.

[0011] Solutions to Solve Problems

[0012] One embodiment of the present invention is a tool for bone surgery, comprising: a main body, which is cylindrical and has a through hole that penetrates the main body in the long side direction and allows a rod-shaped component to be inserted; a receiving part, which is arranged at a distance from one end of the main body in the above-mentioned long side direction and is opposite to the above-mentioned one end of the main body in the above-mentioned long side direction; and a hook-shaped support connecting the above-mentioned main body and the above-mentioned receiving part, and the above-mentioned receiving part receives one end of the above-mentioned rod-shaped component that penetrates the above-mentioned through hole of the above-mentioned main body.

[0013] Effects of the Invention

[0014] According to the present invention, it is possible to achieve an effect of preventing the tip of the drill bit that has penetrated the bone from being exposed to the surrounding tissue. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Figure 1 It is a side view showing the overall structure of an example of a bone surgery tool according to one embodiment of the present invention.

[0016] Figure 2 It is a perspective view showing the overall structure of another example of the bone surgery tool according to the embodiment of the present invention.

[0017] Figure 3 It is a side view showing the overall structure of another example of the bone surgery tool according to the embodiment of the present invention.

[0018] Figure 4 It is a perspective view showing the overall structure of another example of the bone surgery tool according to the embodiment of the present invention.

[0019] Figure 5 This is a diagram showing an example of use of a bone surgery tool.

[0020] Fig. 6A It is a three-dimensional view of the receiving surface where the anti-slip member is provided.

[0021] Figure 6B It is a three-dimensional diagram of the receiving surface on which the protrusion is provided.

[0022] Figure 6C It is a three-dimensional view of the receiving surface where the recess is provided.

[0023] Fig. 7A This is an overall structural diagram of a bone surgery tool in which a bone gripping portion is provided on a rod portion.

[0024] Figure 7B Yes means Fig. 7A A diagram showing an example of use of a bone surgery tool.

[0025] Figure 8 It is a side view of the receiving part where the visual confirmation part is provided.

[0026] Fig.9A The diagram explains how to use a bone surgery tool as an implant guide.

[0027] Fig. 9B The diagram explains how to use a bone surgery tool as an implant guide.

[0028] Fig. 10A It is a diagram for explaining the method of using the bone surgery tool as a guide for temporary fixation.

[0029] Fig. 10B It is a diagram for explaining the method of using the bone surgery tool as a guide for temporary fixation.

[0030] Fig. 10C It is a diagram for explaining the method of using the bone surgery tool as a guide for temporary fixation.

[0031] Fig.11 This is a diagram for explaining how to use a bone surgery tool as a compression tool.

[0032] Fig. 12A It is a diagram for explaining HTO and DOT.

[0033] Fig. 12B This is a diagram illustrating the relationship between the movement of the knee and the load applied to the rough surface in DTO. DETAILED DESCRIPTION

[0034] Hereinafter, a bone surgery tool 1 according to an embodiment of the present invention will be described with reference to the drawings.

[0035] The bone surgery tool 1 is a drill guide used in an operation to insert an implant such as a screw or a pin into a bone A and to guide a drill (a rod-shaped member) for opening a lower hole for implantation in the bone A. Figure 1 As shown, the bone surgery tool 1 includes a rod portion (main body portion) 2 for guiding a drill, a receiving portion 3 that is opposite to the front end of the rod portion 2 in the longitudinal direction of the rod portion 2 and receives the front end of the drill, and a hook-shaped support 4 that connects the rod portion 2 and the receiving portion 3.

[0036] The rod part 2 and the receiving part 3 are arranged on both sides of the bone A in the radial direction to radially grasp the bone A. A lower hole is made in the radial direction of the bone A by a drill inserted into the rod part 2 .

[0037] The rod portion 2 is a cylindrical shape extending linearly, and has a through hole 2a that penetrates in the long side direction of the rod portion 2 and is inserted into the drill bit. The diameter of the through hole 2a is slightly larger than the outer diameter of the drill bit, for example, 1.6 mm to 7 mm. In the through hole 2a, the drill bit is guided in the long side direction of the rod portion 2 along the central axis of the through hole 2a. The drill bit can be a commercially available drill bit for perforating bones. Alternatively, the bone surgery tool 1 can have a special drill bit suitable for the rod portion 2 and the receiving portion 3.

[0038] The annular front end surface of the rod portion 2 has depressions at multiple positions in the circumferential direction, and a tip 2b protruding toward the receiving portion 3 is formed between the depressions. The tip 2b can more stably hold the bone A, and the vibration of the drill bit can be suppressed when the drill bit is used to make a lower hole. Instead of the tip 2b, a protrusion protruding toward the receiving portion 3 can be provided at the front end of the rod portion 2.

[0039] The receiving portion 3 is a plate-shaped component that is orthogonal to the extension line of the central axis of the through hole 2a, and is arranged at a position spaced apart from the front end of the rod portion 2 along the long side direction of the rod portion 2. The surface of the receiving portion 3 on the rod portion 2 side is a receiving surface 3a that is opposite to the opening of the through hole 2a in the front end of the rod portion 2. The receiving portion 3 receives the front end of the drill that penetrates the through hole 2a and protrudes from the front end of the rod portion 2 on the receiving surface 3a. The receiving surface 3a can be a flat surface or a curved surface along the surface shape of the bone A. In a plan view observed along the direction of the central axis of the through hole 2a, the receiving portion 3 has a circular, elliptical or other arbitrary shape.

[0040] It is preferred that the outer dimensions of the receiving portion 3 in the radial direction orthogonal to the long side direction of the rod 2 are larger than the outer dimensions of the drill bit in the radial direction. According to this structure, the front end of the drill bit can be reliably received by the receiving portion 3, and the front end of the drill bit that has penetrated the bone A can be accurately prevented from being exposed to the tissue around the bone A. In this case, the drill bit can be provided as a component of the bone surgery tool 1.

[0041] The radial outer dimensions of the receiving portion 3 may be the same as the radial outer dimensions of the rod portion 2. According to this configuration, when the bone surgery tool 1 is observed from the base end side of the rod portion 2, the location of the receiving portion 3 in the body can be confirmed by an X-ray observation device or the like.

[0042] The support column 4 is bent in a substantially U-shape or a substantially C-shape and is arranged radially outside the bone A so as to surround approximately half of the circumference of the bone A. The rod portion 2 is supported at one end of the support column 4 so as to be movable in the longitudinal direction of the rod portion 2, and the receiving portion 3 is fixed to the other end of the support column 4. Considering the width of the skin incision for inserting the bone surgery tool 1 into the body, the distance D between the central axis of the through hole 2a in the radial direction and the support column 4 is preferably about 15 mm to 70 mm.

[0043] A cylindrical support portion 4a is provided at one end of the support column 4, which can support the rod portion 2 movably in the long side direction of the rod portion 2. The support portion 4a is a female thread having a thread groove formed on the inner peripheral surface. A male thread 2c connected to the female thread is provided on the cylindrical outer peripheral surface of the rod portion 2. The rod portion 2 moves toward the receiving portion 3 by rotating the rod portion 2 around the long side axis of the rod portion 2, and moves away from the receiving portion 3 by the reverse rotation of the rod portion 2. In addition, when the rotation of the rod portion 2 stops, the rod portion 2 is positioned relative to the support column 4 in the long side direction, and the distance between the front end of the rod portion 2 and the receiving portion 3 is fixed. Therefore, the distance between the front end of the rod portion 2 and the receiving surface 3a is adjusted according to the thickness of the bone A, and bones A of various thicknesses can be firmly grasped by the rod 2 and the receiving portion 3.

[0044] Figure 2 Another example of the bone surgery tool 1 according to this embodiment is shown. Figure 2 In the example of , the outer circumference of the rod 2 and the inner circumference of the support 4a are smooth, and the support 4a supports the rod 2 so that it can move smoothly along the longitudinal direction. A limiter 4b for temporarily fixing the rod 2 relative to the support 4a is provided on the support column 4. The limiter 4b is a knob screw, such as a butterfly screw, that penetrates from the outside to the inside of the support 4a in the radial direction. The rod 2 is fixed relative to the support 4a by rotating the knob screw 4b, and the fixation of the rod 2 relative to the support 4a is released by reverse rotation of the butterfly screw 4b.

[0045] Figure 3 Another example of the bone surgery tool 1 according to this embodiment is shown. Figure 3 In the example of , a latch mechanism is provided for positioning the rod portion 2 in the longitudinal direction relative to the support portion 4a. The latch mechanism includes a plurality of grooves 2d formed on the outer peripheral surface of the rod portion 2 and arranged in the longitudinal direction of the rod portion 2, a protrusion 4c provided at one end of the support 4, and a biasing member 4d. The protrusion 4c is biased toward the rod portion 2 by the biasing member 4d such as a spring and is embedded in the groove 2d. In a state where the protrusion 4c is embedded in the groove 2d, the rod portion 2 is positioned in the longitudinal direction relative to the support portion 4a. In addition, when a force in the longitudinal direction of a certain magnitude or more is applied to the rod portion 2, the rod portion 2 overcomes the force of the biasing member 4d and pushes the protrusion 4c and moves in the longitudinal direction.

[0046] The groove 2d may have a shape that restricts movement of the rod 2 in only one direction. For example, the latch mechanism may allow movement of the rod 2 only in a direction approaching the receiving portion 3 like a ratchet mechanism. In addition to the latch mechanisms 2d, 4c, 4d, a pin or a screw for mechanically fixing the rod 2 relative to the support portion 4a may be provided.

[0047] like Figure 4As shown, a scale 4e may be provided on the outer peripheral surface of the rod 2. The scale lines of the scale 4e are arranged in the long side direction of the rod 2. For example, a doctor can measure the distance between the tip of the rod 2 and the receiving part 3 based on the value of the scale 4e at the position of the supporting part 4a.

[0048] Next, the function of the bone surgery tool 1 will be described.

[0049] Figure 5 DTO (distal-tuberosity osteotomy) is shown as an example of use of the bone surgery tool 1. DTO is a method of performing osteotomy at a position farther from the rough surface B in high tibial osteotomy (HTO) in order to make the rough surface B continuous with the proximal bone fragment C of the tibia A.

[0050] Furthermore, the bone surgery tool 1 can also be used to create a lower hole in a bone other than the tibia.

[0051] like Figure 5 As shown, the rod 2 and the receiving portion 3 are used to clamp the tibia A in the front-to-back direction at the position of the rough surface B, and the rod 2 is moved in a direction close to the receiving portion 3 until the front end of the rod 2 and the receiving surface 3a of the receiving portion 3 contact the surface of the tibia A. Thus, the tibia A is held in the radial direction by the rod 2 and the receiving portion 3. At this time, the rod 2 is arranged on the front side of the tibia A, and the receiving portion 3 is arranged on the rear side of the tibia A.

[0052] Secondly, a drill bit 10 is inserted into the through hole 2a of the rod 2, and a lower hole is made on the tibia A by the rotating drill bit 10. In the making of the lower hole, since the drill bit is guided straightly along the central axis of the through hole 2a, a lower hole extending straightly along the extension line of the central axis of the through hole 2a can be made. Secondly, the drill bit 10 is pulled out from the lower hole and the through hole 2a, and the depth of the lower hole is measured using a depth gauge (omitted from the figure) to confirm that the depth of the lower hole is appropriate. Secondly, an implant is inserted into the lower hole of the tibia A, and the rough surface B is fixed on the distal bone piece of the tibia A by the implant. A measuring function for measuring the thickness of the tibia A can be provided in the bone surgery tool 1.

[0053] Thus, according to the present embodiment, the receiving portion 3 is arranged on the opposite side of the bone A and the rod portion 2, and the drill bit 10 guides the rod portion 2 straightly into the bone A toward the receiving portion 3. Furthermore, when the drill bit 10 penetrates the bone A, the front end of the drill bit 10 hits the receiving surface 3a on the surface of the bone A and is blocked by the receiving portion 3. Thus, the front end of the drill bit 10 is prevented from being exposed to the tissue around the bone A, and the tissue around the bone A can be reliably protected from the front end of the drill bit 10. In the case of DTO, the front end of the drill bit 10 that penetrates the tibia A from the front to the back can be reliably prevented from being exposed to the nerves and blood vessels existing at the back of the tibia A.

[0054] In the above embodiment, if Fig. 6A As shown, an anti-slip member 5 can be provided on the receiving surface 3a to prevent the receiving surface 3a from sliding relative to the surface of the bone A. The anti-slip member 5 is composed of, for example, a plurality of grooves or a plurality of protrusions formed on the receiving surface 3a. The anti-slip member 5 can stably position the receiving portion 3 on the surface of the bone A.

[0055] In addition, in the above embodiment, if Figure 6B As shown, a convex portion (engaging portion) 3b protruding toward the rod portion 2 can be provided on the receiving surface 3a. The convex portion 3b is provided at a position radially deviated from the drill bit in a manner that does not hinder the movement of the drill bit in the long side direction. For example, in the case of using a hollow drill bit, the convex portion 3b can be provided at the center portion of the receiving surface 3a. When the front end of the drill bit is arranged on the receiving surface 3a or in the vicinity of the receiving surface 3a, the front end portion (engaging portion) of the drill bit is radially engaged with the convex portion 3b, and the drill bit is radially aligned with respect to the receiving portion 3. As a result, the position of the front end of the drill bit relative to the receiving portion 3 can be made more stable.

[0056] In the above embodiment, if Figure 6C As shown, a recess 3c which is recessed toward the side opposite to the rod 2 and can receive the tip of the drill bit can be provided in the center of the receiving portion 3a. According to this structure, a hole can be drilled reliably to the front of the end of the cortical bone.

[0057] In the above embodiment, if Fig. 7A as well as Figure 7B As shown, a bone gripping portion 6 may be provided at the front end of the rod portion 2. The bone gripping portion 6 has a bone gripping surface 6a on the side of the receiving portion 3. The bone gripping surface 6a is recessed toward the side opposite to the receiving portion 3 and is curved along the surface of the bone A clamped between the receiving portion 3 and the bone gripping surface 6a. By providing the bone gripping surface 6a, the contact area with the bone A can be increased, and the bone A can be gripped more stably. Fig. 7A as well as Figure 7B , the bone gripping surface 6a that is curved in one direction is shown as an example. The shape of the bone gripping surface 6a can be changed as long as the bone gripping surface 6a is arranged along the surface of the bone A and can grip the bone A.

[0058] In order to make the curvature direction of the bone gripping surface 6a coincide with the curvature direction of the surface of the bone A, the rod portion 2 may be supported by the support portion 4a so as to be rotatable about the longitudinal axis. Fig. 7A as well as Figure 7B In the example of FIG. 4 , the outer peripheral surface of the rod 2 and the inner peripheral surface of the support 4a are provided with a male thread 2c and a female thread connected to each other. The rod 2 is supported by the support 4 so as to be swingable around an axis in a direction perpendicular to the longitudinal axis.

[0059] In the above-mentioned embodiment, the receiving portion 3 may include a visual confirmation portion that can be observed through the biological tissue by an observation device.

[0060] The observation device is a device that allows visual inspection through biological tissues such as bones and their surrounding tissues, such as an X-ray observation device. Figure 8 As shown, the visual confirmation portion 7 is a mark constituting a part of the receiving portion 3. For example, the mark 7 is formed of an X-ray opaque material, or a material different from other parts of the receiving portion 3, such as a resin. Alternatively, the visual confirmation portion may be a through hole or a thin-walled portion formed in the central portion of the receiving portion 3. The diameter of the through hole as the visual confirmation portion is smaller than the diameter of the drill bit, for example, the diameter is 0.5 mm to 3 mm. The thin-walled portion is thinner than other parts of the receiving portion 3, for example, having a thickness of 0.5 mm to 1.0 mm.

[0061] During surgery, if the receiving part 3 is arranged on the opposite side of the bone A from the doctor and is blocked by the bone A, the doctor cannot visually see the receiving part 3. By providing the visual confirmation part 7 at a part of the receiving part 3, the doctor can observe the receiving part 3 using an observation device.

[0062] In the above embodiment, the support column 4 supports the rod portion 2 movably in the longer direction. Instead, the rod portion 2 may be fixed to one end of the support column 4 .

[0063] In this case, the distance between the tip of the rod portion 2 and the receiving surface 3 a of the receiving portion 3 is designed according to the thickness of the bone A to which the bone surgery tool 1 is applied.

[0064] The bone surgery tool 1 can also be used for other purposes besides the drill guide. FIG. 9A to FIG. 11 As shown, the bone surgery tool 1 can also function as an implantation guide, a temporary fixation guide, or a compression tool.

[0065] Fig.9A as well as Fig. 9B The method of using the bone surgery tool 1 as an implant guide is shown. The bone surgery tool 1 is used together with a drill sleeve 20 for making a lower hole. The inner diameter of the through hole 2a of the rod part 2 is slightly larger than the outer diameter of the drill sleeve 20. The outer diameter of the drill sleeve 20 is equal to or slightly larger than the outer diameter of the implant. The diameter of the through hole 2a of the rod part 2 is preferably 3 mm to 8 mm.

[0066] like Fig.9A As shown, the bone A is held radially by the rod 2 and the receiving portion 3, a drill sleeve 20 is inserted into the through hole 2a of the rod 2, and a drill 10 is inserted into the bone A through the drill sleeve 20 to make a lower hole. Fig. 9BAs shown, the drill sleeve 20 is pulled out from the rod part 2, and an implant 30 such as a screw is inserted into the through hole 2a of the rod part 2. As a result, the implant 30 can be inserted into the lower hole coaxially with the lower hole. Fig.9A as well as Fig. 9B As shown, a slit 2e for visually observing the implant 30 in the rod portion 2 can be provided in the rod portion 2. For example, the slit 2e extends from the recess between the tips 2b to the base end side. Based on the position of the implant 30 in the rod portion 2 observed through the slit 2e, the insertion amount of the implant 30 into the lower hole can be visually confirmed.

[0067] FIG. 10A to FIG. 10C The following describes a method of using the bone surgery tool 1 as a temporary fixation guide.

[0068] like Fig. 10A As shown, a cylindrical sleeve 40 for guiding a metal wire for temporary fixation is inserted into the through hole 2a of the rod portion 2. The sleeve 40 has a through hole that penetrates the sleeve 40 in the longitudinal direction and into which the metal wire is inserted. The diameter of the metal wire is preferably 1.2 mm to 3 mm. The sleeve 40 appropriately fitted into the through hole 2a of the rod portion 2 can be provided as a component of the bone surgery tool 1. Fig. 10B As shown, the drill sleeve 20 can be inserted into the through hole 2 a of the rod part 2 , and the sleeve 40 can be inserted into the drill sleeve 20 .

[0069] Then, if Fig. 10C As shown, a wire 50 is inserted into the bone A through the sleeve 40, and the bone A and the rod 2 are temporarily fixed by the wire 50. Next, the sleeve 40 is pulled out from the rod 2, and a hollow drill is inserted into the through hole 2a of the rod 2 along the wire 50, and a lower hole is made in the bone A by the drill.

[0070] Fig.11 The following shows how to use the bone surgery tool 1 as a compression tool.

[0071] like Fig.11 As shown, a pushing member 60 having a pin 60a at the front end is inserted into the through hole 2a of the rod portion 2. The pushing member 60 is a solid rod-shaped member. And, the bone A, such as the rough surface B, is pressed toward the receiving portion 3 by the pin 60a. Thus, compared with the case where the front end of the rod portion 2 is used for pressing, the compressive force can be reliably applied to the bone piece of the rough surface B. In order to maintain the state of pressing the bone A, the pushing member 60 can be fixed relative to the rod portion 2 by a pin 70 that penetrates the rod portion 2 and the pushing member 60 in the radial direction.

[0072] Explanation of symbols

[0073] 1—tool for bone surgery, 2—rod part (main body), 2a—through hole, 3—receiving part, 3a—receiving surface, 3b—convex part (engaging part), 4—pillar, 5—anti-slip part, 6a—bone holding surface, 7—visual confirmation part, 10—drill bit (rod-shaped part), A—bone.

Claims

1. A bone surgery tool, characterized in that: have: A main body portion, which is cylindrical and has a through hole that penetrates the main body portion in the longitudinal direction of the main body portion and into which the rod-shaped member is inserted; a receiving portion, which is arranged at a distance from one end of the main body in the longitudinal direction and is opposed to the one end of the main body in the longitudinal direction, so as to hold the bone between the receiving portion and the one end of the main body; a hook-shaped support connecting the main body and the receiving portion; and a cylindrical sleeve, which is engaged with the through hole of the main body, and is used to guide the insertion of a metal wire for temporary fixing, and has a through hole penetrating in the longitudinal direction. The metal wire is inserted into the through hole of the sleeve to temporarily fix the main body and the bone. The sleeve is pulled out from the main body, and the rod-shaped member is inserted into the through hole of the main body along the wire, so that the receiving portion receives one end of the rod-shaped member that penetrates the bone.

2. The bone surgery tool according to claim 1, characterized in that: The one end of the main body has a bone gripping surface. The bone grasping surface is recessed on the side opposite to the receiving portion and is arranged along the surface of the bone.

3. The bone surgery tool according to claim 1 or 2, characterized in that: The receiving portion has a visual confirmation portion that can be observed through biological tissue by an observation device.

4. The bone surgery tool according to claim 1 or 2, characterized in that: The receiving portion has a non-slip member on a receiving surface that contacts the one end of the rod-shaped member.

5. The bone surgery tool according to claim 1 or 2, characterized in that: The invention comprises the above-mentioned rod-shaped member, An outer dimension of the receiving portion in a direction intersecting with a longitudinal direction of the main body is larger than an outer dimension of the rod-shaped member in a direction intersecting with the longitudinal direction of the main body.

6. The bone surgery tool according to claim 5, characterized in that: The receiving portion and the rod-shaped member each have an engaging portion that engages with each other in a direction intersecting with the longitudinal direction of the main body. Through the engagement of the engaging portions, the receiving portion and the rod-shaped member overlap with each other in the direction intersecting with the longitudinal direction of the main body.

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